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Upper limb tremor induced by peripheral nerve injury
J Costa1, R Henriques, C Barroso
1Department of Neurology, Hospital Santa Maria., Av Prof Egas Moniz., 1649-028 Lisbon, Portugal.
Neurology
|November 30, 2006
Summary
A patient developed upper limb tremor after thoracic surgery due to a peripheral nerve lesion. Electromyography confirmed neurogenic abnormalities, suggesting a peripheral cause for the persistent tremor.
Area of Science:
- Neurology
- Neurosurgery
- Peripheral Nerve Disorders
Background:
- Thoracic surgery can lead to iatrogenic nerve injuries.
- Peripheral nerve lesions are a potential cause of movement disorders.
Observation:
- A patient presented with a proximal right upper limb tremor following thoracic surgery.
- Electromyography (EMG) revealed neurogenic abnormalities in muscles innervated by the thoracodorsal and long thoracic nerves.
- The tremor was present during both REM and non-REM sleep.
Findings:
- The tremor was attributed to a direct peripheral nerve lesion.
- Standard neurological investigations including evoked potentials, transcranial magnetic stimulation, and spinal MRI were unremarkable.
- Persistent tremor during sleep stages suggests a peripheral generator rather than a central nervous system origin.
Implications:
- This case highlights a rare complication of thoracic surgery.
- It underscores the importance of considering peripheral nerve injury in the differential diagnosis of post-operative tremors.
- Further research into peripheral tremor generators may be warranted.
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